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Articles by S. D. Kim
Total Records ( 2 ) for S. D. Kim
  H. S Na , J. T Kim , H. S Kim , J. H Bahk , C. S Kim and S. D. Kim
  Background

Various methods have been recommended to decide a proper insertion depth of central venous catheter (CVC). The carina is recommended as a useful target level for the CVC tip position. We evaluated the sternal head of a right clavicle and the nipples as anatomic landmarks for determining the optimal depth of CVC in paediatric patients.

Methods

Ninety children, <5 yr, undergoing catheterization through the right internal jugular vein were enrolled. The insertion depth was determined as follows. The insertion point was designated as ‘Point I’. The sternal head of the right clavicle was called ‘Point A’ and the midpoint of the perpendicular line drawn from Point A to the line connecting both nipples was called ‘Point B’. The insertion depth of CVC was determined by adding the two distances (from I to A and from A to B) and subtracting 0.5 cm from this. A chest radiography was taken and the distance of the CVC tip from the carina level was measured by the Picture Archiving and Communicating System.

Results

The mean distance of the CVC tip from the carina level was 0.1 (1.0) (P=0.293) cm above the carina (95% CI 0.1 cm below the carina–0.3 cm above the carina). There was no specific relationship between the distance of the CVC tip from the carina level and the patients’ age, height, and weight.

Conclusions

The CVC tip could be placed near the carina by using the external landmarks without any formulae, images, and devices in children in our study.

  S. J Park , H. Y Yoo , Y. E Earm , S. J Kim , J. K Kim and S. D. Kim
  Background

The roles of arachidonic acid (AA) metabolites in hypoxia-induced pulmonary vasoconstriction (HPV), a critical physiological mechanism that prevents ventilation/perfusion mismatch, are still incompletely understood.

Methods

Pulmonary arterial pressure was measured in ventilated/perfused rat lungs. Isometric tones of rat intralobar pulmonary arteries were also measured, using a myograph.

Results

Hypoxia (Po2, 3%)-induced pulmonary arterial pressure increases (PAPhypox) were stable with blood-mixed perfusate, but decayed spontaneously. PAPhypox was inhibited by 29%, 16%, and 28% by the thromboxane A2 (TXA2) antagonist SQ-29548, the 5-lipoxygenase inhibitor, MK886, and the leukotriene D4 antagonist, LY-171883, respectively. The prostacyclin synthase inhibitor tranylcypromine augmented PAPhypox by 5%, whereas inhibition of cytochrome P450 did not affect PAPhypox. Consistently, the TXA2 analogue U46619 increased PAPhypox whereas prostacyclin abolished PAPhypox. However, leukotriene D4 had no direct effect on PAPhypox. In the isolated pulmonary arteries, pretreatment with U46619 was essential to demonstrate hypoxia-induced contraction.

Conclusions

The above results suggest that TXA2 and cysteinyl leukotrienes, other than leukotriene D4, are endogenous factors that facilitate HPV in rats. The indispensable role of TXA2-induced pretone in the HPV of isolated pulmonary arteries indicates that the signal from thromboxane receptors might be a critical component of oxygen sensation mechanisms.

 
 
 
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